A Hostile Climate for People Who Use Drugs Hurts Everyone

We’ve made much-needed societal progress on mental health and sexuality, but drug use stigma remains common.

Amidst our politically correct awakening, people are standing up for any injustice or discrimination they perceive. But, when it comes to off-hand comments related to illicit drug use, the warriors who fight so hard on the internet sometimes fall silent.

Our society has made much-needed progress erasing stigma surrounding such things as mental health and sexuality—but when it comes to how we treat people who use drugs, it's a frontier we haven't yet crossed. We forget that people who use drugs are humans too, who deserve to be treated as such despite what you may think of how they live their lives.

"For over a hundred years, people who use drugs have been driven into the shadows, into prisons, driven out of jobs, have been driven out of families, driven out of communities," said Donald MacPherson, executive director of the Canadian Drug Policy Coalition. "It's a big hole we've dug for ourselves."

On Tuesday, US Attorney General Jeff Sessions praised the anti-drug program DARE (which is known to have been ineffective), saying, "We have to create a cultural climate that is hostile to drug abuse." The thing is, we are already hostile—and inflaming this already-hostile feeling society has could mean even more dire consequences for people who use drugs.

Examples of jokes and inappropriate statements regarding drug use—like making fun of someone you deem a "crack addict"—are everywhere, from social media timelines to conversations amongst friends to media. So is the normalization of using someone's drug habits to point to them being a bad person.

These words are said despite the fact that we are living through the opioid crisis, which is claiming thousands of lives across the US and Canada annually; they're said despite the genocide being waged on people who use and/or sell drugs in the Philippines. Here are a few examples from last week:

On Thursday, I was reading a story about feral cats overtaking a neighbourhood when a quotation pointing to the stigmatization of addiction came up, seemingly out of nowhere: "It's like having a bunch of druggies on your streets… All we want to do is clean up the neighbourhood," a Cornwall, Ontario resident told CBC News about cats. Yes, about cats. No one asked for people who use drugs to be brought up. Alas, here we were.

There was also the attack Rob Kardashian launched on social media targeting his ex Blac Chyna in which, in addition to revenge porn, pointed to her allegedly using drugs: "And here comes to the drunk and on drugs Chyna," Kardashian posted on Instagram. "Thank god for the constant messages of Chyna asking me for… cocaine, molly, and X. Get it together for your daughter."

Even more disturbingly, look at what people in leadership roles have said as people in their communities die from overdose during the opioid crisis. A Middleton, Ohio council member suggested the city stop emergency response to overdose calls—in one of the states most affected by the crisis.

MacPherson said that the failure to address stigma around drug use could be, in part, because people don't readily recognize addiction as a temporary disability. "There hasn't been a human rights component discussion around people who use drugs, whereas with disability or developmental disabilities, there has been a much greater understanding."

But not everyone who uses drugs is addicted. Dr. Hakique Virani, a public health and addictions specialist in Edmonton, Alberta said that we can't just talk about reducing stigma around drug use due to the connection addiction can have to trauma or other mental health conditions.

"Sometimes it's just that some people do drugs," he told VICE. "There's this idea that if you have difficulty identifying with somebody, you don't advocate for them—that's really, really sad."

Virani has had people question whether he does drugs because of advocating for those do. When he did a radio essay for CBC about drugs, "People Use Drugs, Get Over It," his mom received a number of phone calls questioning his own habits.

"It's not surprising that we're having problems bringing people who use drugs out of the shadows, because there's that complexity of the criminalized people, criminalized substances," MacPherson told VICE.

Alex Betsos, volunteer coordinator for Vancouver-based harm reduction group Karmik and strategic advisor for Canadian Students For Sensible Drug Policy, said that stigma persists amongst people who use drugs too.

"What I find interesting about working with people who use drugs is that you'll find people in drug subcultures who stigmatize other people's substance use or even who don't consider what they're doing substance use," Betsos said.

"People are very comfortable with distancing themselves from that 'other' group of people—in the same way that you have people in the LGBTQ+ community who might not be comfortable with people who are trans, or trans-exclusionary radical feminism."

As well, Betsos said, the history of substance use is tied to certain marginalized populations, so we tend to separate and stigmatize based on those associations. For instance, there's a heavier stigma tied to crack use than cocaine use.

"It's not OK to discriminate on any prohibited ground, and health condition is prohibited ground; addiction is a health condition."

MacPherson also referenced the hierarchy of stigma amongst drugs, pointing to "so-called consciousness-expanding drugs" such as psychedelics being seen as more acceptable. Previously, he said, these drugs were associated with "underground chemists" rather than organized crime groups, such as the Hells Angels. Part of the reason the hierarchy might have begun to exist in the first place, according to MacPherson, could be because of the level of criminality related to specific drugs. However, now the drug market has changed: "Some of the busts [today] you'll see dealers are carrying all sorts of drugs."

"Even if we spent millions on stigma-reducing campaigns… Criminalization still exists," MacPherson said. "It's a total mess to undo, and that's why if we were to regulate [drugs], we could separate those strands and just deal with people who have addiction problems."

MacPherson said the opioid crisis has started a conversation around these issues, but that "it's silly people have to die for us to deal with stigma." He said that in urban centres, such as Vancouver, there has been some progress regarding stigmatization due to strong political leadership.

Dr. Virani, who works in another place heavily affected by the opioid crisis, Alberta, said that "We should never be OK for treating someone differently for race or for sexual preference or for sex—we kind of get that [as a society]... It's not OK to discriminate on any prohibited ground, and health condition is prohibited ground; addiction is a health condition."

But again, as Virani pointed out, some people just want to do drugs—they might not be addicted or have a mental health-related reason for doing so.

"Substance use should be treated no differently: That might not be OK for you, but it also shouldn't be OK for you to treat them differently."